바로가기메뉴

본문 바로가기 주메뉴 바로가기

A Case of Ectopic Adrenocorticotropic Hormone Syndrome in Small Cell Lung Cancer

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2015, v.78 no.4, pp.436-439








  • Downloaded
  • Viewed

Abstract

Small cell lung cancer (SCLC), which originated from neuroendocrine tissue, can develop into paraneoplastic endocrine syndromes, such as Cushing syndrome, because of an inappropriate secretion of ectopic adrenocorticotropic hormone (ACTH). This paraneoplastic syndrome is known to be a poor prognostic factor in SCLC. The reason for poor survival may be because of a higher risk of infection associated with hypercortisolemia. Therefore, early detection and appropriate treatment for this syndrome is necessary. But the diagnosis is challenging and the source of ACTH production can be difficult to identify. We report a 69-year-old male patient who had severe hypokalemia, metabolic alkalosis, and hypertension as manifestations of an ACTH-secreting small cell carcinoma of the lung. He was treated with ketoconazole and spironolactone to control the ACTH dependent Cushing syndrome. He survived for 15 months after chemotherapy, which is unusual considering the poor outcome of the ectopic ATH syndrome associated with SCLC.

keywords
ACTH Syndrome, Ectopic, Small Cell Lung Carcinoma, Paraneoplastic Syndromes

Reference

1.

1. Mayer S., Cypess AM., Kocher ON., Berman SM., Huberman MS., Hartzband PI. (2005), Uncommon presentations of some common malignancies: Case 1. Sequential paraneoplastic endocrine syndromes in small-cell lung cancer. J Clin Oncol, 23,1312-4.

2.

2. Howlett TA., Rees LH., Besser GM. (1985), Cushing’s syndrome. Clin Endocrinol Metab, 14,911-45.

3.

3. Liddle GW., Givens JR., Nicholson WE., Island DP. (1965), The ectopic ACTH syndrome. Cancer Res, 25,1057-61.

4.

4. Nieman LK. (1997), Cushing’s syndrome. Curr Ther Endocrinol Metab, 6,161-4.

5.

5. Shepherd FA., Laskey J., Evans WK., Goss PE., Johansen E., Khamsi F. (1992), Cushing’s syndrome associated with ectopic corticotropin production and small-cell lung cancer. J Clin Oncol, 10,21-7.

6.

6. Abeloff MD., Trump DL., Baylin SB. (1981), Ectopic adrenocorticotrophic (ACTH) syndrome and small cell carcinoma of the lungassessment of clinical implications in patients on combination chemotherapy. Cancer, 48,1082-7.

7.

7. Kenchaiah M., Hyer S. (2012), Cushing’s syndrome due to ectopic ACTH from bronchial carcinoid: a case report and review. Case Rep Endocrinol, 2012,215038.

8.

8. Yang HJ., Sung HJ., Kim JE., Lee HJ., Park JM., Park CK. (2007), A case of ectopic ACTH syndrome associated with small cell lung cancer presented with hypokalemia. J Korean Endocr Soc, 22,359-64.

9.

9. Izzedine H., Besse B., Lazareth A., Bourry EF., Soria JC. (2009), Hypokalemia, metabolic alkalosis, and hypertension in a lung cancer patient. Kidney Int, 76,115-20.

10.

10. Dimopoulos MA., Fernandez JF., Samaan NA., Holoye PY., Vassilopoulou- Sellin R. (1992), Paraneoplastic Cushing’s syndrome as an adverse prognostic factor in patients who die early with small cell lung cancer. Cancer, 69,66-71.

11.

11. Sarlis NJ., Chanock SJ., Nieman LK. (2000), Cortisolemic indices predict severe infections in Cushing syndrome due to ectopic production of adrenocorticotropin. J Clin Endocrinol Metab, 85,42-7.

12.

12. Lokich JJ. (1982), The frequency and clinical biology of the ectopic hormone syndromes of small cell carcinoma. Cancer, 50,2111-4.

13.

13. Ejaz S., Vassilopoulou-Sellin R., Busaidy NL., Hu MI., Waguespack SG., Jimenez C. (2011), Cushing syndrome secondary to ectopic adrenocorticotropic hormone secretion: the University of Texas MD Anderson Cancer Center Experience. Cancer, 117,4381-9.

Tuberculosis & Respiratory Diseases